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chloramphenicol
generic
Black Box Warnings .
Appropriate Use
hospitalize patients for observation and hematologic monitoring during administration
Blood Dyscrasias
serious and fatal blood dyscrasias (including aplastic or hypoplastic anemia, thrombocytopenia, and granulocytopenia) may occur with short or prolonged tx; some reports of aplastic anemia ended in leukemia; avoid use in trivial infections or where not indicated or when safer alternate tx exists
Adult Dosing .
Dosage forms: INJ
infections, bacterial
- [50-100 mg/kg/day IV divided q6h]
- Max: 100 mg/kg/day; Info: not considered 1st line tx for any infection; adjust dose based on levels
infections, rickettsial
- [50-100 mg/kg/day IV divided q6h]
- Max: 100 mg/kg/day; Info: not considered 1st line tx for any infection; adjust dose based on levels
meningitis, bacterial
- [4 g/day IV divided q6h]
- Alt: 75-100 mg/kg/day IV divided q6h; 6 g/day IV divided q6h if pneumococcal; Info: not considered 1st line tx; adjust dose based on levels
anthrax, systemic (off-label)
- [1 g IV q6-8h for at least 2wk]
- Info: not 1st-line agent; part of multi-drug regimen; switch to PO antibiotic x60 days if aerosol exposure
renal dosing
- [see below]
- renal impairment: decr. usual dose, amount not defined
- HD: no adjustment, on dialysis days administer after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: no adjustment; no supplement
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined
Peds Dosing .
- Dosage forms: INJ
infections, bacterial
- [premature neonates <1.2 kg]
- Dose: 22 mg/kg/dose IV qd; Start: 20 mg/kg/dose IV x1; Info: give 1st maintenance dose 12h after start dose; adjust dose based on levels; premature neonates >1.2 kg use same dosing as full-term neonates
- [neonates 0-7 days old or <2 kg]
- Dose: 25 mg/kg/dose IV qd; Start: 20 mg/kg/dose IV x1; Info: give 1st maintenance dose 12h after start dose; adjust dose based on levels
- [neonates >7 days old and >2 kg]
- Dose: 50 mg/kg/day IV divided q12h; Start: 20 mg/kg/dose IV x1; Info: adjust dose based on levels
- [infants/children]
- Dose: 50-75 mg/kg/day IV divided q6h; Max: 4 g/day; Info: adjust dose based on levels
meningitis
- [infants/children]
- Dose: 75-100 mg/kg/day IV divided q6h; Max: 4 g/day; Info: adjust dose based on levels
anthrax, systemic (off-label)
- [neonates >32 wk gestation]
- Dose: 25-50 mg/kg/dose IV q12-24h for at least 2wk; Info: for CNS anthrax; not 1st-line agent; part of multi-drug regimen; dose, frequency depend on gestational and post-natal age; switch to PO abx x60 days total if inhalational exposure
- [1 mo and older]
- Dose: 100 mg/kg/day IV divided q6h for at least 2wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; switch to PO antibiotic x60 days total if aerosol exposure
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined